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Health-related Internet use among cancer survivors: data from the Health Information National Trends Survey, 2003–2008

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Increasing prevalence of Internet and new technologies are changing the communication pattern for patients and caregivers across the cancer care continuum. To date, little is known on how cancer survivors in the USA utilize the Internet for health-related purposes. This knowledge is crucial in developing effective communication programs to achieve quality and equitable cancer care.


Data from 2003, 2005, and 2008 iterations of the NCI-sponsored Health Information National Trends Survey(HINTS) were analyzed to: (1) compare health-related Internet use (hereafter HRIU) between individuals with and without a cancer diagnosis, (2) report trends, prevalence, and user profiles of HRIU, including support group participation, emailing provider, buying medicine online, and cancer information seeking on the Internet. Descriptive analyses and weighted multivariate logistic regression analyses were performed.


While Internet penetration is growing over the years across the USA, cancer survivors access the Internet at a lower rate than general population (49.4% to 56.4% vs. 63.1% to 66.3%). Once on the Internet, they are more likely to use it for health-related purposes. Disparities in Internet access persists, as higher likelihood of Internet access is associated with younger age, higher education, non-Hispanic White race/ethnicity, metropolitan residence, and better self-rated health. On the other hand, among Internet-accessing survivors, socio-demographic, and health factors do not play a significant role in determining the pattern of HRIU.


The study identifies an increasing trend in HRIU among survivors, though the digital divide remains in Internet access. The findings also point to opportunities for narrowing the divide and using Internet to better serve survivors’ needs, as individuals from wide-ranging backgrounds and experiences are equally engaging in health-related activities on the Internet.

Implications for survivors

To increase equity and effectiveness in communication and cancer care, Internet access, functions, and technology literacy are important factors to be considered.

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  1. Bargh JA, McKenna KY. The internet and social life. Annu Rev Psychol. 2004;55:573–90.

    Article  PubMed  Google Scholar 

  2. Beckjord EB, Arora NK, McLaughlin W, Oakley-Girvan I, Hamilton AS, Hesse BW. Health-related information needs in a large and diverse sample of adult cancer survivors: implications for cancer care. J Cancer Surviv. 2008;2(3):179–89.

    Article  PubMed  Google Scholar 

  3. Fox S, Purcell K. Chronic disease and the Internet (2010). Accessed 31 March 2010

  4. Eheman CR, Berkowitz Z, Lee J, Mohile S, Purnell J, Rodriguez EM, et al. Information-seeking styles among cancer patients before and after treatment by demographics and use of information sources. J Health Commun. 2009;14(5):487–502.

    Article  PubMed  Google Scholar 

  5. Hesse BW, Arora NK, Burke Beckjord E, Finney Rutten LJ. Information support for cancer survivors. Cancer. 2008;112(11 Suppl):2529–40.

    Article  PubMed  Google Scholar 

  6. Rutten LJ, Arora NK, Bakos AD, Aziz N, Rowland J. Information needs and sources of information among cancer patients: a systematic review of research (1980–2003). Patient Educ Couns. 2005;57(3):250–61.

    Article  PubMed  Google Scholar 

  7. Mayer DK, Terrin NC, Kreps GL, Menon U, McCance K, Parsons SK, et al. Cancer survivors information seeking behaviors: a comparison of survivors who do and do not seek information about cancer. Patient Educ Couns. 2007;65(3):342–50.

    Article  PubMed  Google Scholar 

  8. Ziebland S. The importance of being expert: the quest for cancer information on the Internet. Soc Sci Med. 2004;59(9):1783–93.

    Article  PubMed  Google Scholar 

  9. Ziebland S, Chapple A, Dumelow C, Evans J, Prinjha S, Rozmovits L. How the internet affects patients' experience of cancer: a qualitative study. BMJ. 2004;328(7439):564.

    Article  PubMed  Google Scholar 

  10. Pereira JL, Koski S, Hanson J, Bruera ED, Mackey JR. Internet usage among women with breast cancer: an exploratory study. Clin Breast Cancer. 2000;1(2):148–53. discussion 154–5.

    Article  PubMed  CAS  Google Scholar 

  11. Hardyman R, Hardy P, Brodie J, Stephens R. It's good to talk: comparison of a telephone helpline and website for cancer information. Patient Educ Couns. 2005;57(3):315–20.

    Article  PubMed  Google Scholar 

  12. Beaver K, Booth K. Information needs and decision-making preferences: comparing findings for gynaecological, breast and colorectal cancer. Eur J Oncol Nurs. 2007;11(5):409–16.

    Article  PubMed  Google Scholar 

  13. Verhoef MJ, Trojan L, Armitage GD, Carlson L, Hilsden RJ. Complementary therapies for cancer patients: assessing information use and needs. Chronic Dis Can. 2009;29(2):80–8.

    PubMed  CAS  Google Scholar 

  14. Atkinson NL, Saperstein SL, Pleis J. Using the internet for health-related activities: findings from a national probability sample. J Med Internet Res. 2009;11(1):e4.

    Article  PubMed  Google Scholar 

  15. Klemm P, Bunnell D, Cullen M, Soneji R, Gibbons P, Holecek A. Online cancer support groups: a review of the research literature. Comput Inform Nurs. 2003;21(3):136–42.

    Article  PubMed  Google Scholar 

  16. Kagan SH, Clarke SP, Happ MB. Head and neck cancer patient and family member interest in and use of E-mail to communicate with clinicians. Head Neck. 2005;27(11):976–81.

    Article  PubMed  Google Scholar 

  17. Beckjord EB, Finney Rutten LJ, Squiers L, Arora NK, Volckmann L, Moser RP, et al. Use of the internet to communicate with health care providers in the United States: estimates from the 2003 and 2005 Health Information National Trends Surveys (HINTS). J Med Internet Res. 2007;9(3):e20.

    Article  PubMed  Google Scholar 

  18. Katzen C, Solan MJ, Dicker AP. E-mail and oncology: a survey of radiation oncology patients and their attitudes to a new generation of health communication. Prostate Cancer Prostatic Dis. 2005;8(2):189–93.

    Article  PubMed  CAS  Google Scholar 

  19. Bylund CL, Gueguen JA, D'Agostino TA, Imes RS, Sonet E. Cancer patients' decisions about discussing Internet information with their doctors. Psychooncology. 2009;18(11):1139–46.

    Article  PubMed  Google Scholar 

  20. McMullan M. Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. Patient Educ Couns. 2006;63(1–2):24–8.

    Article  PubMed  Google Scholar 

  21. Murray E, Lo B, Pollack L, Donelan K, Catania J, White M, et al. The impact of health information on the internet on the physician-patient relationship: patient perceptions. Arch Intern Med. 2003;163(14):1727–34.

    Article  PubMed  Google Scholar 

  22. Nelson DE, Kreps GL, Hesse BW, Croyle RT, Willis G, Arora NK, et al. The Health Information National Trends Survey (HINTS): development, design, and dissemination. J Health Commun. 2004;9(5):443–60. discussion 81–4.

    Article  PubMed  Google Scholar 

  23. Cantor D, Coa K, Crystal-Mansour S, Davis T, Dipko S, Sigman R. Health Information National Trends Survey (HINTS) 2007 final report. Rockville: Westat; 2009.

    Google Scholar 

  24. Rizzo L, Moser RP, Waldron W, Wang Z, Davis WW. Analytic methods to examine changes across years using HINTS 2003 and 2005 data. USA: National Cancer Institute; 2008.

    Google Scholar 

  25. Demographics of Internet users, November19–December 20, 2008 Tracking Survey. Accessed 27 March 2009

  26. Sarkar U, Karter AJ, Liu JY, Adler NE, Nguyen R, Lopez A, et al. The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system-results from the diabetes study of northern California (DISTANCE). J Health Commun. 2010;15 Suppl 2:183–96.

    Article  PubMed  Google Scholar 

  27. Chou WY, Hunt YM, Beckjord EB, Moser RP, Hesse BW. Social media use in the United States: implications for health communication. J Med Internet Res. 2009;11(4):e48.

    Article  PubMed  Google Scholar 

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Correspondence to Wen-ying Sylvia Chou.

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Chou, Wy.S., Liu, B., Post, S. et al. Health-related Internet use among cancer survivors: data from the Health Information National Trends Survey, 2003–2008. J Cancer Surviv 5, 263–270 (2011).

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